The medicalisation of solid waste: Coordination challenges of domestic biomedical risk waste in illegal dumping sites in informal settlements in Cape Town

The study evaluates the emerging health and safety coordination challenges Cape Town faced in the management of illegally dumped domestic biomedical waste in informal settlements. The COVID-19 pandemic highlighted the emerging health challenge of illegally dumped domestic biomedical waste because of the volume of healthcare waste and hazardous materials found in domestic waste. This regularly causes local pandemics and chronic health conditions among the residents of informal settlements. Due to the inaccessibility of these settlements and the lack of suitable infrastructure, illegally dumped domestic biomedical risk waste requires specialised manual removal and treatment by trained and equipped personnel. To limit the transmission of disease resulting from the illegal dumping of biomedical waste, waste management procedures require certain deviations from conventional waste management practices and bylaw regulations for rapid mass waste removal. This deviation includes the provision of adequate bins and refuse bags, where most practical, to the impacted population. It also requires strong bylaw enforcement to ensure reasonable public compliance when it limits rapid removal procedures, the retraining and re-quipping of personnel, and frequent decontamination procedures. Flexible procedures are also needed for novel forms of biomedical waste, such as cigarette butts and animal carcasses. Finally, cost-effective and efficient domestic biomedical risk waste management requires direct multi-modal trans-jurisdictional communication, prioritising the disposal of hazardous waste between different departments and governments.